Professional New Hire/Re-Hire Checklist


Policy Statements

Workers' Compensation Information

EMPLOYEE Occupational Accidents / Injuries / Illnesses

What to do if you are injured at work.

  1. Report all accidents, injuries or illnesses to your supervisor, no matter how minor.
  2. Complete the following forms:

    1. Written Statement - Incident Report
    2. C-1 Notice of Injury or Occupational Disease
    3. if appropriate the Report of Exposure to Bloodborne Pathogens. SEE LINKS BELOW
    4. >
    5. If you need medial attention, please contact your supervisor immediately.
    6. If the injury is life threatening or an emergency call 911 (9-911 from a campus line) or proceed to the nearest medical facility. In this case, complete the C-1 Notice of Injury or Occupational Disease as soon as feasible.
    7. If emergency treatment is not required, you must seek medical evaluation by one of the approved medical providers listed in the Workers' Compensation Information link below.
      NOTE: Under Nevada Law, an employee is required to seek medical treatment from an approved clinic, UNLESS EMERGENCY TREATMENT IS REQUIRED.

    8. Tell the doctor you were injured at work.
    9. The healthcare provider must complete a C-4 Employee Claim for Compensation/Report of Medical Treatment (the official claim form) at the doctor's office. Must be completed within 90 days from the date of injury.
    10. >Following the medical visit contact the Workers' Compensation Administrator for further assistance. SEE BELOW
    11. Communicate with your supervisor regarding the outcome of the medical evaluation, treatment and any work restrictions ordered by the healthcare provider.
    12. Stay in touch with the workers' compensation administrator.



      Must submit the Supervisor's Injury / Illness / Incident Report to Workers' Compensation Office. SEE LINK BELOW

    Workers' Compensation Program

    CSN's Workers' Compensation Insurance Program is administered at Nevada System of Higher Education, Business Center South located on UNLV campus.  View the Workers' Compensation Insurance information for CSN employees.

    Workers' Compensation Program - Approved Medical Clinics

    View the APPROVED MEDICAL CLINICS for work-related, non-emergency injury or illness.

    Workers' Compensation Administrator

    Michele Washington
    NSHE Business Center South / UNLV Risk Management and Safety
    fax 702-895-5227
    Contact Us

    Forms & Resources


Health Insurance

Affordable Care Act Information [pdf]
Employee Hiring Form (State of Nevada - PEBP). If covering dependent(s), copy of certified marriage certificate required for spouse coverage and copy of birth certificate(s) required for children. PEBP will send packet to enroll.
State of Nevada (PEBP) basic life insurance policy ($25,000), the Standard Insurance Company, Beneficiary Designation

Additional Volunteer Supplemental Deductions

Request for Supplemental Retirement and Insurance/Products Information [pdf]

  • Tax-Sheltered Annuities (403B, 403B Roth, 457 Plans)
  • Salary Redirection Agreement (For "ASI, Inc.," pre-tax flexible spending accounts - medical and dependent care)
  • Cancer Care Policy - American Fidelity
  • Short-Term Disability - American Fidelity & Standard Insurance
  • Personal Accident Policy - The Hartford
  • Liberty Mutual Automobile/Homeowner's Insurance
  • Supplemental Policies through MetLife

Information Provided

CSN Strategic Plan for 2010-2017 [pdf]
Employee Assistance Program
Health Insurance Comparisons and Provider Directories
Retirement Plan Alternative (RPA) Guide
Professional Grant-in-Aid Procedures
State Training [pdf]
Resources for Success [pdf]

Human Resources information contained on the World Wide Web is in no way to be interpreted as a contract between the College of Southern Nevada and any of its employees. This information is provided as a service to the CSN community and will change as CSN changes. From time to time, CSN must modify its policies. Information is current as of the time of its presentation and may be subject to change or repeal at any time, with or without notice, at the discretion of CSN.